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For the latest cutting-edge research, innovative collaborations and remarkable discoveries in child health, read stories from across all our areas of study in Q: Advances and Answers in Pediatric Health.
Inguinal Hernia and Hydrocele
We specialize in the big things, the small things and everything in between.
What is an inguinal hernia and hydrocele?
When a boy is developing, the testicles begin in the belly and travel down the abdomen and through the inguinal canal. As they do this, they bring with them part of the lining of the abdomen, which is called the processus vaginalis. The processus vaginalis creates an opening from the abdomen, down to the scrotum, where the testicles eventually settle. Once in the scrotum, the opening (processus vaginalis) typically closes. If the opening does not close properly, tissue or liquid can move from the abdomen into the scrotum, which causes an inguinal hernia or a hydrocele.
Inguinal hernias and hydroceles are both characterized by swelling of the groin and scrotum (testicle sac). The swelling can also extend into the groin (the inner area of the hip between the stomach and the thigh).
If the opening left by the processus vaginalis is small, only fluid can pass through, and the swelling this creates in the scrotum is called a hydrocele, or a non-communicating hydrocele. However, if the opening is large enough, a part of the intestine can move into the scrotum and this is called an inguinal hernia or communicating hydrocele. Learn how our doctors repair a hernia.
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What causes inguinal hernia and hydrocele?
Hernias and hydroceles in children are usually congenital, meaning they are present at birth. The hernia or hydrocele sac occurs when the opening left by the processus vaginalis allows fluid or part of the intestine into the scrotum. The opening should normally close on its own during development, but it remains open in some people. When the opening to the sac is wide, parts of the abdomen (bowel and fat) can enter the sac and make it become an inguinal hernia. If the opening is only wide enough to let in fluid, this creates a hydrocele.
Who gets hernias and hydroceles?
Hernias and hydroceles occur in about 1 out of 100 boys and hernias occur less commonly in girls. They are also more common in children who are born prematurely and in children with a family history of these conditions.
What are the signs and symptoms of a hernia or hydrocele?
A hydrocele usually causes scrotal swelling that gradually decreases in size. A hernia usually causes intermittent swelling of the groin that may extend into the scrotum. This is usually most noticeable when your child is crying or having a bowel movement, or at the end of the day.
A hydrocele does not typically cause any pain or problems. Both conditions are usually identified shortly after birth. However, an inguinal hernia or hydrocele may show up later in life following periods of increased strain. Children experiencing signs or symptoms of a hydrocele or hernia should see a pediatric urologist or pediatric surgeon as soon as possible.
An incarcerated inguinal hernia can happen when a firm mass within the groin extends into the scrotum – it occurs when a bowel movement gets stuck in the hernia sac. It is usually tender to the touch and may cause nausea and vomiting or a change in bowel habits. This is an emergency and should be addressed immediately.
What tests are used to diagnose a hernia or hydrocele?
Most of the time, your child’s doctor can diagnose a hernia or hydrocele with a physical exam. Occasionally, a doctor will recommend a scrotal ultrasound to confirm the diagnosis. Ultrasound scans are painless imaging tests that use sound waves to take pictures of the inside of the body. An ultrasound takes about 30 minutes, with results the same day.
How is a hernia or hydrocele treated?
Hydroceles diagnosed in newborns will often go away on their own before a baby’s first birthday. If it persists, we may recommend surgical treatment.
We typically treat an inguinal hernia with surgery. Your child’s surgeon makes a small incision in the groin and ties off the hernia sac. If the fluid around the testicle remains, the testicle is delivered through the incision and the fluid-filled sac around the testicle – a non-communicating hydrocele – is opened. The testicle is then returned to the scrotum and the incision is closed.
Why choose Children's Hospital Colorado for your child's hernia or hydrocele treatment?
At Children's Colorado our pediatric surgeons and pediatric urologists have significant experience in diagnosing and treating hernias and hydroceles. We understand the difference between the two conditions and know when they need to be corrected. We work in an operating room specifically designed for children, with the purpose of minimizing any fear or discomfort they may have.
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